Valleywise Prop 409 seeks approval on Election Day in Arizona

On Election Day, held Tuesday, Nov. 4, voters in Maricopa County had the opportunity to vote on a $898 million bond proposal, Proposition 409. Valleywise Health had asked voters to approve the proposal to expand access to vital care across Maricopa County. The proposed bond was approved unanimously by the Maricopa County Special Health Care District Board of Directors on April 24, 2025.

If Prop 409 passes, it will authorize the county to use property taxes to obtain $898 million in bonds for Valleywise Health, the county-owned hospital chain. Valleywise, which is Phoenix’s largest provider of inpatient behavioral health care, plans to use the money to upgrade current facilities and build new ones.

Steve Purves, President & CEO, Valleywise, joined “Arizona Horizon” to discuss more on the Prop 409 after election day in Arizona.

At last check, the measure was passing by a narrow margin: about 10,900 votes.

“It’s a close vote,” Purves said, “but we feel very confident in terms of where things stand.”

He noted that voter awareness played a major role. “Once people know what we do, where we do it, how we do it, there’s quite a bit of support,” he said.

If the result holds, Purves said Valleywise will be able to move forward with the next phase of its master facilities plan, including a significant expansion of behavioral health services.

“We have an old facility on our campus that’s not in keeping with the standards of care,” he explained. The bond would replace it with a new 200-bed behavioral health hospital—adding about 100 new beds to meet rising demand.

The funds would also support $500 million in outpatient health facilities, including a long-needed replacement for the South Central Family Medicine Center.

“It is by any stretch outdated,” Purves said. “This will bring comfort and dignity to patients and improve our clinical learning environment.”

Additional investments include a new outpatient specialty care clinic and an outpatient surgery center, which Purves says will offer more efficient care and reduce pressure on inpatient services.

Valleywise also plans to expand its main hospital by adding observation beds and building out the shelled 10th floor to keep up with record-high emergency and inpatient volumes.

Some critics questioned the tax increase, estimated at $29 per year for a typical homeowner, but Purves emphasized Valleywise’s longstanding role as the county’s public safety-net system.

“We serve a very underserved population,” he said, noting that federal law requires all hospitals to treat and stabilize any patient who enters an emergency department, regardless of status or ability to pay. “It’s an unfunded mandate.”

But not one that shifts costs to taxpayers through Medicaid, as undocumented individuals do not qualify for the program.

If Prop 409 officially passes, planning will begin immediately, though construction will take several years to launch.

“It’s a long-term process,” Purves said. “But we’re ready to get started.”